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Afrilia Mauly; Dewi Nurfaizah Haryanto; Suci Pidiawati; Dilla Kurnia; Ratih Kusuma Dewi

Jurnal Kesehatan dan Kedokteran 2025 Lembaga Pengembangan Kinerja Dosen

Hypotension following spinal anesthesia is a frequent perioperative complication, particularly among pregnant patients, with an incidence ranging from 60% to 80%. This condition may compromise uteroplacental perfusion and pose serious risks to both mother and fetus. Leg elevation represents a simple, safe, inexpensive, and effective non-pharmacological intervention that functions through gravitational autotransfusion, enhancing venous return and improving cardiac output. This scoping review was conducted using the Joanna Briggs Institute (JBI) methodology and the PRISMA-ScR framework, guided by the PICO approach. The population included adult patients undergoing spinal anesthesia, with the intervention consisting of elevating the legs at an angle of 20–30° or approximately 30 cm for 10–15 minutes, compared with the standard supine position. Literature searches were performed through PubMed  and Google Scholar, focusing on primary studies published within the last five years. Of the 130 articles identified, 10 met the inclusion criteria and were analyzed descriptively. The findings demonstrate that leg elevation significantly increases systolic and diastolic blood pressure as well as mean arterial pressure (MAP), while reducing the incidence of post-spinal hypotension. The technique also decreases vasopressor requirements without notable adverse effects, particularly in obstetric populations. Based on the available evidence, leg elevation is recommended as an effective and feasible initial non-pharmacological strategy for preventing hypotension after spinal anesthesia, especially in resource-limited clinical settings, with an optimal elevation of 20–30° for 10–15 minutes.

Armila Damayanti; Resti Yuliati Sutrisno; Purnomo Widiyanto

Jurnal Ilmu Kesehatan Umum, Psikolog, Keperawatan dan Kebidanan 2024 Asosiasi Riset Ilmu Kesehatan Indonesia

Chronic Kidney Failure (CKD) is a kidney disease caused by damage or dysfunction in the kidneys. A common problem in CKD sufferers is excess fluid which causes swelling in the extremities (edema). The causes of edema in CKD patients are failure to comply with fluid restrictions, lack of dietary control, fluid and sodium retention. One of the independent nursing interventions that is very effective for treating edema is ankle pump exercise therapy with leg elevation at 30 ̊. The case study was carried out in the hemodialysis unit at Dr. Tjitrowardojo Purworejo. The aim of the study was to identify the effect of providing ankle pump exercise therapy and 30° leg elevation intervention to reduce edema in CKD patients. The research design used is a descriptive method with a case study approach. The subjects of this case study are CKD patients undergoing hemodialysis who experience edema and patients who have signed an informed consent form. The instrument used is a monitoring sheet for the degree of edema. The intervention given in this case study was ankle pump exercise therapy and 30° leg elevation which was carried out for 7 minutes in 3 meetings over 7 days. Evaluation was carried out on days 1, 4, 8. The results showed that the degree of edema on the first day was grade III (5mm), on the second day it was grade II (4mm), on the third day it was grade I (2mm). Based on the results of the case study, it can be concluded that the application of ankle pump exercise and 30° elevation has proven effective in reducing the degree of edema in chronic kidney failure, so that this independent nursing intervention can be carried out by nurses for CKD patients undergoing hemodialysis.

Arifin Noor, Mohammad; Riska, Wulan Maulia; Suyanto, Suyanto; Wahyuningsih, Indah Sri

JURNAL KEPERAWATAN SISTHANA 2023 SEKOLAH TINGGI ILMU KESEHATAN KESDAM IV DIPONEGORO

Introduction: Chronic Kidney Disease (CKD) is a condition in which the kidneys have experienced functional or structural damage or disturbances. The condition of the kidney that has decreased function is unable to dispose of waste products through urination which can result in disruption of endocrine, fluid, electrolyte, metabolic and acid-base functions, one of the consequences of which is the occurrence of edema. The prevalence of kidney failure in Central Java reached 0.42% with a total of 96,794 sufferers. The impact of edema that is not treated will result in respiratory, cardiovascular systems, neurological systems. The purpose of this study was to see the effect of a combination of ankle pump exercise and 30° foot elevation on edema in CKD patients at the Sultan Agung Islamic Hospital in Semarang. Method: This research is a quantitative study using a pre-experimental pretest-posttest design approach. The sample is 12 respondents with purposive sampling technique. Results: The results of this study were mostly male with a total of 10 with a percentage of 83.3% with an average age of 44.50. the results of the bivariate analysis with the Marginal Homogeneity Test obtained a significant value of p = 0.001 (<0.05). Conclusion: There is an effect of a combination of ankle pump exercise and 30° foot elevation on foot edema in CKD patients.